Provider Demographics
NPI:1194946509
Name:AIROZO, ANTONIA CATON IV (MA)
Entity type:Individual
Prefix:MS
First Name:ANTONIA
Middle Name:CATON
Last Name:AIROZO
Suffix:IV
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 LA PLAYA ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-1009
Mailing Address - Country:US
Mailing Address - Phone:720-621-0459
Mailing Address - Fax:
Practice Address - Street 1:245 11TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-3732
Practice Address - Country:US
Practice Address - Phone:415-355-0311
Practice Address - Fax:415-355-0353
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA70369OtherMARRIAGE AND FAMILY THERAPIST INTERN NUMBER